Here's What Experts Have To Say About Headaches & Labor
What causes pregnancy headaches, and how to treat them.
For many parents-to-be, the last few weeks of pregnancy can be particularly stressful. While consistent contractions and your water breaking are obvious signs of labor, it's impossible not to analyze every twinge, pain, and symptom as a hint it's "go time." So, is a headache a sign of labor? While every pregnant person, and every pregnancy, is different, there are a few things every soon-to-be parent should know as they nears they due date.
To find out more about if pregnancy headaches are a sign of impending labor, what a headache at 38 weeks pregnant might mean, and what you should do if you experience a headache before labor, here’s what experts want you to know.
Reasons you get a headache during pregnancy
Unfortunately, as it turns out, headaches during pregnancy are fairly a common occurrence. And as doula and birthing expert Sara Lyon explains, the timing during your pregnancy will likely give you some answers as to why it’s happening. “Anecdotally, I don’t see more headaches in pregnancy after first trimester than in the non-pregnant population,” Lyon tells Romper. “First trimester, however, comes with so many rapid changes that headaches are very common.”
As it turns out, hormonal headaches are all too common early on. “Headaches in the first trimester of pregnancy are commonly caused by dehydration, hormones shifting, increased blood volume, poor sleep, tension or stress and caffeine withdrawal,” Lyon says. “Dehydration is avoidable as long as you are able to keep water down — in the case of hyperemesis gravidarum, you might need IV hydration. Hormones do change throughout pregnancy, and this factor will usually subside in second trimester. Likewise, by second trimester, the body has usually adjusted to the increased blood volume. Caffeine withdrawal will usually last a week or two.”
However, if you are experiencing prolonged, painful headaches in the later stages of pregnancy, something might be up and you should check with your doctor. “Later in pregnancy, 20+ weeks, a persistent headache should be reported to your medical care provider,” Lyon says. “A migraine-like headache can be a sign of high blood pressure and you will be screened for preeclampsia.”
Is a headache ever a sign of labor?
Though you might think that a hormonal headache before labor sounds like a thing that would happen to pregnant people, the truth is that probably won’t be the case. But a headache isn't a likely sign that you're about to give birth, according to Dr. Huma Farid, M.D., an OB-GYN at Harvard Medical School and Beth Israel Deaconess Medical Center in Boston, Massachusetts. "I do not typically consider headaches as a sign of labor," Farid tells Romper. But pregnancy itself is full of headache triggers. "Headaches may be a sign of dehydration, sleep deprivation or stress, or more concerning, may be the first sign of preeclampsia," Farid says. "Migraines can occur in pregnancy, but are more common when someone has a history of migraines prior to pregnancy."
This can be even more of a pain — literally — than usual, because there are not as many treatment options for headaches during pregnancy. "I advise my patients to hydrate, rest, and take acetaminophen if they experience a headache," Farid says. "If the headache is not resolving with these measures or is intensifying, or they have any blood pressure abnormalities, I advise them to come in right away to be evaluated."
Before you dismiss your late pregnancy headache as just another pregnancy pain, you should know that a sudden-onset of a severe headache in late pregnancy might be an early symptom of a preeclampsia. “A headache is not a common sign of labor, although it is within normal symptoms,” Lyons says. “After 20 weeks, be sure to report a severe headache to your medical care provider so that they can screen for preeclampsia.”
"Preeclampsia occurs in pregnant women after 20 weeks of gestation; women develop elevated blood pressure, headaches, visual changes, and abdominal pain. They may also develop abnormal liver or kidney function tests," Farid explains. "Preeclampsia is a very serious consideration and requires management of blood pressure and symptoms, and evaluation in the hospital." Per the Preeclampsia Foundation, preeclampsia rates have increased in the U.S. to 25% in the past 20 years, and it is key cause of maternal death.
It's always a good idea to ask your doctor or midwife about a headache, even if you think it's no big deal. In fact, a 2015 study published in the journal Neurology found that one-third of pregnant women who went to the ER for a headache in the third trimester were found to have a secondary condition, with half of those being preeclampsia or pregnancy hypertension.
Treating headaches during pregnancy
However, if your head pounding is simply just a headache — there are lots of non-pregnancy related factors that could cause one — there are some remedies you can turn to to ease the pain. “Massage therapy is a safe treatment that will increase circulation and reduce tension, while also benefitting the quality of your sleep,” Lyon says. “Increase your water intake to avoid dehydration and help your body adjust to the new demands of pregnancy. Medically, acetaminophen is safe for pregnancy, and you can check with your care provider to hear about alternative medications.”
Whatever the reason for your pregnancy headache, be it caused by hormones, sleep-deprivation, or something more serious, the best way to figure out what’s going on is to contact your health care provider. And as soon as that’s taken care of, you can relax before other reasons for headaches kick in with time (read: raising a newborn!).
Robbins, M., Farmakidis, C., Dayal, A., Lipton, R. (2015) Acute headache diagnosis in pregnant women: A hospital-based study. Neurology, http://n.neurology.org/content/early/2015/08/19/WNL.0000000000001954
Sara Lyon, birthing expert, doula, author of The Birth Deck and You’ve Got This: Your Guide to Getting Comfortable with Labor
Dr. Huma Farid, M.D., OB-GYN at Harvard Medical School and Beth Israel Deaconess Medical Center
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